COA Releases Biosimilars Position Statement

The Community Oncology Alliance (COA) recently released a position statement about biosimilars, saying it will work with stakeholders to support the acceptance of biosimilars as well as work to close knowledge gaps, given the burdensome cost of cancer care.

The statement comes from the COA’s Biosimilars Committee, which was formed in January to begin educating oncologists and to assess the prevalence of biosimilars in the current market as an appropriate treatment option.

COA said it will work with manufacturers of biologics and biosimilars to reduce the cost of care, improve access, and reduce financial toxicities while continuing to provide logistical support for innovation in cancer treatment

US total spending on cancer care has increased from $27 billion in 1990 to $124 billion in 2010, with spending projected to reach around $174 billion by 2020, the organization said; this increase will happen across all phases of care.

However, besides higher spending on cancer care, the other piece that is different from years ago is that patients are shouldering an increasing share of these rising costs as health plans restructure benefits to include high-deductible health plans that shift costs to beneficiaries. Financial consequences can be devastating to patients and families.

The fastest-growing drug classes within oncology are biologics, accounting for over 40% of US oncology spending. Sales figures in 2015 for 3 of the top 20 global products—bevacizumab, rituximab, and trastuzumab, all of which have FDA-approved by not-yet-launched biosimilars—were $6.2 billion, $6.3 billion, and $5.6 billion, respectively.

In addition, the increased prevalence of cancer, earlier treatment initiation, and improved patient outcomes all contribute to the growing use of oncology and supportive care biologic agents, as well as the overall high cost of cancer care.

By 2020, a range of biosimilars for biologic agents used in oncology treatment are expected to receive FDA approval.

COA cited Congressional Budget Office (CBO) estimates that the sales-weighted market average discount on biosimilars would be 20% to 25% relative to reference agents in the first year. In the fourth year, the CBO estimates this would reach about 40%. The Rand Corporation estimates that savings to the US health care system resulting from the use of biosimilars over biologics range from an estimated $13 billion to $66 billion over the 10-year period between 2014 and 2024.

The organization also cited the role that biosimilars will play in value-based care models such as the Oncology Care Model and the Medicare Shared Savings Program.

However, any projected cost savings depend on how biosimilars are embraced and used. Numerous surveys have found a lack of awareness about biosimilars among providers.

Patient education is also key to increasing acceptance of biosimilars, COA notes.

The authors of the statement are Kashyap Patel, MD, a practicing medical oncologist at Carolina Blood and Cancer Care in South Carolina, chair of the COA Biosimilars Committee, and an advisory board member for The Center for Biosimilars®; Edward “Randy” Broun, MD; Leslie “Les” Busby, MD; Steve D’Amato, BScPharm; Marsha DeVita, NP; Michael Diaz, MD; Kathy Oubre, MS; Bob Phelan; William “Bud” Pierce, MD; and Jeff Vacirca, MD, FACP.